US House Passes Fix For Medicare Physician Payment System
The bill would repeal the current system of paying physicians under Medicare and thus avoid perennial shortfalls stemming from a complex formula, known as the sustainable growth rate, that determines the payments.
It was passed by a 243-183 vote.
The bill would prevent a 21% drop in physician payments slated for January. It is paired with a "pay-as-you-go" measure that would statutorily require Congress to offset most spending bills with new revenue.
Despite the scheduled cut in Medicare payments to doctors, the House bill faces an uncertain future in the Senate. The Senate voted 53-47 against proceeding to a similar bill in October.
The American Medical Association, the largest doctors' group in the U.S., has urged passage of the House Medicare physician payment bill, along with a broader health-care overhaul passed by the House, earlier this month. House Republicans, however, said the bill was a "pay-off" to the AMA and maligned the lack of a "pay-for" to cover its estimated $210 billion in costs over the next decade.
"We are here today considering this latest deficit spending bill because [Democratic] leaders refuse to address health care reform in a fiscally responsible way," said Rep. Mike Pence, (R, Ind.).
But House Majority Steny Hoyer, (D, Md.), pointed to bill passed when Republicans controlled Congress, such as President Bush's 2001 and 2003 tax cuts, that increased the budget deficit.
"It is true that ensuring our seniors access to their doctors will add to our deficit, just as extending any of the Bush tax cuts that are set to expire next year would do," Hoyer said. "Because seniors' health is at stake in this bill, I believe that stopping these payment cuts is worth the cost."
The physician payment fix would replace the current payment formula for annual payment increases, with increases equal to 1% more than the annual measurement of gross domestic product for most physician services. For primary care and preventive care - which health policy experts say can reduce medical cost growth - the bill would establish a separate payment rate of 2% more than gross domestic product.
When Senate Democrats tried to pass their own version of the legislation to repeal the current Medicare payment formula for physicians, centrist Democrats balked at the legislation because it did not provide an offset for its estimated $247 billion cost.
One of those Democrats, Senate Budget Chairman Kent Conrad, (D, N.D.), said this week that Congress should seek to avoid the steep cuts in the payment rate slated for next year, but that lawmakers should also pass legislation creating an outside commission to make recommendations on reining in the cost of long-term entitlement programs.
Conrad told reporters that "it makes no sense" to pass a long-term fix of the Medicare payment system without offsetting its cost.
"It's one thing to do that when you're in an economic downturn," Conrad said, but "nobody thinks we're going to be in an economic downturn forever."
Hoyer and other House Democrats have countered that the pay-as-you-go proposal, paired with the Medicare physician payment bill, would begin the work of restraining federal spending. Members of the Blue Dog Coalition, a group of fiscally conservative Democrats in the House, insisted that the physician payment fix should be accompanied by pay-as-you-go legislation.
-By Patrick Yoest, Dow Jones Newswires; 202-862-3554; patrick.yoest@dowjones.com
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Publié le 19 novembre 2009 Copyright © 2009 Dowjones
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